Hair Restoration Blog

Where can we take hair for hair transplant other than the back and sides of the scalp?  This is a common question that I am asked on a regular basis.  The answer is “hair can be harvested from almost any part of scalp or body that grows hair and it can be transplanted to any part of the skin.  We have performed hair transplant from many different areas of the body on patients who do not have sufficient donor hair on their scalp for transplantation or in people who had old hair transplant procedures that violated the donor area with multiple punch biopsies and through scarring.

Pubic area is prepped before harvesting hair for hair transplantation into the balding spot of patient

It is important to understand that scalp donor hair is always the best option when it comes to hair quality for the best result in hair transplant surgery.  The scalp hair has a longer growth phase (anagen) that is about 1-6 years and a shorter resting phase (telogen) that lasts around 4-6 weeks.  This makes scalp hair a more economic choice for hair restoration surgery.  When using scalp hair for donor, almost every transplanted hair stays in growth its phase and only a small portion goes into the dormant phase in which hair falls and another hair grows in a few weeks.

Body hair, in general, has a shorter growth phase which could last only about a few months and a longer resting phase.  That is why body hair never grows more than a certain length.  There are some limited studies that show that transplanted body hair can change their innate characteristics and increase its growth phase when transplanted to the scalp, but we still need more research to provide information on the details of the process.

At US Hair Restoration, we have used pubic hair successfully in a patient with great demand due to his fine scalp hair and violated donor hair that could not provide sufficient hair for transplantation into the scalp.  The patient’s hairline has been restored using scalp hair from the occipital area (back) of the head and the balding spot on the crown was reinforced using pubic hair.

So if you are lacking adequate hair on your donor area of the scalp or need a large number of grafts, you may be able to consider other options including pubic hair transplant.  Obviously, the donor quality should be evaluated closely by a good hair transplant doctor to determine the candidacy of the patient for body hair transplant to scalp.  The details and methodology of this process is being published in medical journals.

Different types of body hair and the indication for the procedure is a question that I have been asked many times in last week. So that is why I thought I should write a post to answer it for everyone. Body hair transplant has been discussed in Hair Restoration Blog in the past in several posts. Patients ask which one is a better source for body hair transplant to the scalp: chest hair, abdominal hair, pubic hair or armpit hair.

Hairs of the body have different characteristics, than hair from the scalp Pubic hair is generally thicker and curlier than other areas of the body. Chest hair may be thick in some patients, but may be finer than scalp hair. Armpit (Axillary) hair is also generally curlier than scalp hair, but may not be as thick as the other types of body hair.

Before deciding to use body hair, a hair transplant surgeon has to examine the scalp donor hair carefully and then only consider body hair if the scalp hair is severely depleted. Depending on the area that you want to use body hair, you may choose different types of body hair. If you want to choose body hair only to fill in the crown area in patients who already have good coverage on top and front, pubic hair could be a good option.

Research has shown that body hair characteristics may change and become longer when transplanted to the scalp. It also shows the anagen phase of body hair may become longer after transplanting it to the scalp. Which is why this is one more advantage for body hair transplant, but still body hair transplantation needs to be done selectively.

Continue from the question “FUE - Body Hair Transplant“

Question 4: What is your view on “out of body” time for grafts?

Answer: There are articles on out if body time for grafts, what we do is to keep grafts in chilled physiologic solution (0-4 C). If grafts are kept in this condition the survival rate is over 90% in up to 12 hours. That number starts to drop gradually after 12 hours.

Question 5: Do your charges apply for every graft extracted, even if transected, or only charge for each intact graft?

Answer: Only the grafts that are intact and transplanted are counted.

Question 6: How much of the work do you do and how much of the work do your Assistants do? What specific tasks are allocated to Assistants and what do you undertake? To what degree are you present in the room where surgery is being carried out? Do you use needle or blade to make incisions?

Answer: In FUE procedures either body hair transplant, or scalp transplant I am present in the OR the whole time because the majority of the work is done by me. I score the grafts and remove them. Techs generally help me in retracting the grafts from scalp. Trimming under microscope is done by technicians. I constantly observe them for the quality and integrity of the grafts. Every now and then, we may have to change our methods for removing FUE grafts in different areas so the surgical team should be constantly communicating with me in the OR. For incisions I usually use solid core needles to minimize the trauma to tissue and preexisting hair.

Here are a series of very good questions on hair transplant with FUE (follicular unit extraction) and body hair transplant from a patient who did his homework and educated himself on his upcoming surgery.

Question 1: Do you have a pre op protocol for chest to scalp?

Answer: For FUE from chest I want to have a clean wet shave from the whole chest one week before the surgery day so in a week when we do harvest the grafts we only remove growing hairs (the ones that are in anagen phase). Scalp hair on the other hand, I don’t want it shaved at all and I will do my own clipping right before the procedure. We do FOX test for all new patients to determine their candidacy for FUE with a small number FUE harvesting under local anesthesia.

Question 2: How many grafts can you transplant per day and how many hours is a typical working day?

Answer: Just for you to get the idea of how long does a FUE hair transplant may take, the last two FUE that we did in US hair restoration office were 1500 grafts per day each. One of them took 9 and the other one 11 hours. In both surgeries we used scalp hair only.

Question 3: Are grafts that are extracted placed straight into the recipient incisions or are they checked under the microscope first?

Answer: All grafts need to be visualized under microscope to make sure they are intact (not transected). Most of them need to be trimmed too. We usually have to remove some of the upper layers of skin and a little of extra fat around the grafts for them to be in the ideal size for transplant.

I will post the rest of this Q and A series in next few days.

Question:
Hi Dr.Mohebi,

I am wondering if the chest hair be transfer to the head?

Yours,

Name

Answer:
Good question and the answer is yes. Some people with limited scalp hair can be good candidates for body hair transplants. This is how it works:

Body hair can be harvested and used for hair transplants in people who have both good course body hair and are severely depleted of scalp donor hair (hair on the sides and back of the head). Body hair should not regularly be used as an alternative to scalp hair for hair transplants. This is because body hair has a short growth cycle in comparison to scalp hair, which makes body hair less desirable than scalp hair for a hair transplant.

Each scalp hair grows between 1 to 6 years and then goes to its resting phase for 4 to 6 weeks in which the hair follicle falls out before the start of another growth cycle. Body hair on the other hand has a different growth cycle, which consists of much shorter growth phase and a longer resting phase. In other words, many body hair follicles that you transplant stay in resting phase most of their lives and only a fraction of them grow and are visible at any given period of time. So you are transplanting hair follicles knowing that not many of them could be seen at any given period of time.

Having said that body hair transplants are OK for people who have no alternative ie. bad donor hair density or quality.